Sexual and Urinary Disorders after Treatment of Rectal Cancer by Radiotherapy and Surgery at the Dantec University Hospital of Dakar

We performed a descriptive retrospective study of sexual and urinary disorders after treatment of rectal cancer by radiotherapy and/or surgery at the Dantec University Hospital in Dakar from 2008 to 2015. The objective of the study was to evaluate these sexual and urinary complications and the factors influencing it. We have collected 50 patients. The average age of is 55.7 years with a sex ratio of 0.78. The dominant clinical signs are rectorrhagia (66.0%). Endoscopy (94.0% of patients) showed an ulcerative-budding appearance in 84.0% of cases. The preferred location was the lower rectum 66.0%). The predominant histologic type is adenocarcinoma lieberkunien (82.0%). Computed tomography is performed in 78% of cases and MRI in 30%. Stage III accounts for 70.0% of cases. Thirty-two patients (64.0%) were treated with conventional 2-beam 2D radiation therapy with or without chemotherapy. The total dose of 46 Gy in 23 sessions was the most used, found in 22 patients;30 Gy in 10 sessions in 9 cases. And 16 Gy in 10 sessions, found in 1 case. Surgery performed was abdominoperineal amputation (58.0%) and conservative surgery (42.0%). We note a complete response in 28.0% of patients;8.0%, an increase of 16.0% and a stabilization of 4.0%. The sexual disorders are more important after radiotherapy compared to non-irradiated patients: 31.3% vs 5.6% (p = 0.035). We observe respectively that 2%, 6% and 8% of our patients had urinary disorders in the form of acute retention, urinary incontinence, and urinary burning. Patient follow-up time was between 0 and 42.83 months with an estimated average of 34.9 ± 3.37. The evolution is marked at 6 months by a persistence of sexual disorders in 63.8% of cases and urinary dysfunction in 4% of cases.

Post-Stroke Sexual Disorders and Its Real-Life Experience within Couples in Brazzaville

Background: Post-stroke sequelae can have repercussions on the sexual life and relational life of patients and their partners. Objectives: To determine the frequencies of sexual disorders after a first stroke event;to identify the factors associated with sexual disorders;to explore the real-life experience of sexual disorders within couples. Methods: It was an analytical cross-sectional study, conducted on patients followed up for a first stroke and their partners. It was carried out at public and private hospitals in Brazzaville, Congo, during the period of patient follow-up, from May to September 2019 (5 months). The Female Sexual Function Index, International Index of Erectile Function 5 and interviews were used to describe sexual aspects. The real-life experience of couples was explored using standardized and pre-established questionnaires. Results: Of the 36 patients who had taken up again sexual intercourse after stroke, 29 (80.6%) were men. Among the post-stroke sexual disorders, erectile dysfunction (53.2%) and ejaculatory dysfunction (40.4%) were the most frequent in men. Decrease of sexual desire was predominant in women (100%). Factors associated with erectile dysfunction were sleep disorder (p = 0.007) and mean sleep duration per night (p = 0.01). Lack of verbal and non-verbal communication of sexual problems and psychological effects was noted in 77.8% of patients and 60% of their partners. The most frequent psychological effects were: in patients, frustration (52.8%), attitude of person decreased (50%) and sadness (41.7%);in partners, attitude of carer (86.7%). Conclusion: Post-stroke sexual disorders are frequent in our context. Sleep disorders and mean sleep duration per night, psychological factors seem to have a negative impact on the sexual life and relational life of stroke patients and their partners. It is important to improve the sex management of couples.

Clinical Observation on Male＇s Sexual Disorder Treated by Acupuncture and Therapeutic Instrument

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EEG Correlations during WCST Performance in Female Adolescents with Sexual Abuse-Related Post-Traumatic Stress Disorder

Child sexual abuse (CSA) survivors can present post-traumatic stress disorder (PTSD) and alterations in EEG activity and cognition. The aim of this study was to evaluate EEG correlations in female adolescents with CSA-related PTSD during performance of the Wisconsin Card-Sorting Test (WSCT). Inter- and intrahemispheric EEG correlations (INTERr and INTRAr) of those subjects were calculated at rest and during performance of WCST. On this task, the PTSD group obtained higher scores than the control group for the number of correct responses and failure to maintain set. In the between-groups comparisons, the PTSD group presented a higher INTERr between frontal areas in the gamma and slow bands, as well as a higher correlation in the delta band at Fp1-F3;however, this group presented a lower INTRAr between Fp1-P3 and Fp2-P4 in the theta and alpha1 bands. In the comparison between conditions, the PTSD group presented an increased correlation during execution of the WCST, mainly in the gamma band, while the control group showed a decrease of INTRAr in the slow bands. Results are discussed with respect to the influence of CSA- related PTSD on the development of cognition and functional connectivity in the brain.

The relationship between child maltreatment and axis I mental disorders: A summary of the published literature from 2006 to 2010

Research has indicated that child maltreatment is associated with an increased likelihood of mental disorders and suicidal ideation and attempts that continues into adulthood. The purpose of this paper is to provide a synopsis of the recent published research from 2006 to 2010 on the association between child maltreatment and Axis I mental disorders and suicidal ideation and attempts. The databases MEDLINE and PsycINFO were searched for relevant and high quality citations up to October 2010. The results indicated that all types of child maltreatment examined are linked to reduced mental health. A general noted trend in the literature is that earlier age of onset of child maltreatment is associated with poorer mental health outcomes. Sex differences do exist with some disorders being more likely among males (e.g., anti-social behaviour) and other more likely among females (e.g., depression, PTSD, substance use disorders) following child maltreatment.

Effective of Behavioral Treatment Combined with Psychological Counseling for Female Coital Disorder of Chinese

Objective: To explore the effects of the behavioral treatment combined with psychological counseling on female coital disorder in China. Methods: One hundred and sixteen female patients with coital disorder were divided into sexual behavior training combined with psychological counseling group (group A, 59 cases) and psychological counseling alone group (group B, 57 cases). Results: Forty-five cases cured (76.27%), eight eases improved (13.56%), and six cases invalid (10.17%), the general rate of effectiveness being 89.83% in group A while eleven cases cured (19.30%), twenty-one cases improved (36.84%), and twenty-five cases invalid (43.86%), the general rate of effectiveness being 56.14% in group B. The curative effect of group A was better than group B (P Conclusions: The behavioral treatment combined with psychological counseling is significantly effective in treating female coital disorder than psychological counseling alone and its long term follow-up results show that most of patients were satisfied with their sex life. However, the response of behavioral treatment of some patients who had bad experience on sexual things in the progress of their growing up or had long course of disease were not so good which deserves our special attention in the future study.

A Juvenile Sex Offender with Attention Deficit Hyperactivity Disorder

Background:Attention deficit hyperactivity disorder(ADHD)is a neurodevelopmental disorder manifesting in early life.These children are more vulnerable to sexual abuse as victims and offenders.Here we describe a teenager with previously undiagnosed ADHD presenting with an alleged act of sexual offending.Case report:According to the 14-year-old accused,he has engaged in penetrative anal intercourse with another school colleague.He also divulged past such incidents involving a teenage male relative and insertion of foreign bodies by him to his anus repeatedly.On assessment the accused had features of inattention such as difficulty in sustaining attention,failing to finish work and features of impulsivity such as difficulty waiting for his turn and intruding on others.He was diagnosed with ADHD according to DSM 5 clinical criteria which were supported by the Sinhalese adaptation of the Swanson,Nolan and Pelham questionnaire.The assessment of the non-verbal intelligence was in the normal range,but his school performance was far below the average.Discussion:Undiagnosed ADHD contributes to academic impairment and inappropriate sexual behaviour.It is possible that the described adolescent’s impulsiveness and inattention contributed to his academic failure and risky sexual behaviour.Early detection and proper management of this disorder may have reduced the risk of such behaviour in him.

人绒毛膜促性腺激素激发试验在性发育异常儿童中的诊断作用评估

目的探讨人绒毛膜促性腺激素(human chorionic gonadotrophin,hCG)激发试验在诊断不同分型性发育异常(disorder of sexual development,DSD)患儿中的价值。方法回顾性分析132例DSD患儿,按染色体核型分为46,XX组(n=10)、46,XY组(n=87)、性染色体异常组(n=35),比较各组患儿hCG激发试验前后的性激素水平,分析形态学上是否存在睾丸组织对hCG激发试验结果的影响。结果3组患儿激发试验后睾酮(testosterone,T)增加倍数比较差异无统计学意义(P>0.05)。46,XY组中,5α-还原酶2缺乏症患儿激发试验后的T与双氢睾酮(dihydrotestosterone,DHT)比值高于其他46,XY DSD患儿(P<0.05)。形态学上,有睾丸组织的DSD患儿激发试验后T增加倍数高于无睾丸组织患儿(P<0.05)。结论hCG激发试验对于评估不同类型的DSD患儿的睾丸间质细胞存在和功能均具有重要价值,对于性腺性质不明确的DSD患儿,均建议行hCG激发试验。

阴道哑铃结合热敏灸、Kegel运动训练治疗产后盆底功能障碍的效果

目的分析阴道哑铃结合热敏灸、Kegel运动训练治疗产后盆底功能障碍(PFD)的效果。方法选择2021年1月至2023年12月诊治的PFD初产妇118例,依照随机抽签法分为观察组和对照组,每组59例。对照组采用阴道哑铃结合Kegel运动训练,观察组给予阴道哑铃结合热敏灸、Kegel运动训练。比较2组治疗效果,干预前后阴道收缩力、盆底肌力、盆底功能、女性性功能指数、尿失禁分级情况。结果观察组总有效率[98.31%(58/59)]高于对照组[84.75%(50/59)](P<0.05)。干预后,观察组阴道收缩力相关指标、盆底肌力、性功能指数均高于对照组(P<0.01);干预后,观察组盆底功能相关评分低于对照组(P<0.01);干预后,观察组尿失禁分级优于对照组(P<0.05)。结论PFD患者经阴道哑铃结合热敏灸、Kegel运动训练干预盆底肌力、盆底功能、尿失禁分级得到了改善,女性性功能指数、阴道收缩力得到了提升,效果较好。

Multiple sclerosis and sexual dysfunction

Multiple sclerosis （MS） is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reactions. The underlying pathogenesis of MS remains largely unclear. However, it is currently accepted as a T cell-mediated autoimmune disease. Among other clinical manifestations, sexual dysfunction （SD） is a painful but still underreported and underdiagnosed symptom of the disorder. SD in MS patients may result from a complex set of conditions and may be associated with multiple anatomic, physiologic, biologic, medical and psychological factors. SD arises primarily from lesions affecting the neural pathways involved in physiologic function. In addition, psychological factors, the side effects of medications and physical symptoms such as fatigue, muscular weakness, menstrual changes, pain and concerns about bladder and bowel incontinence may also be involved. Since MS primarily affects young people, SD secondary to MS may have a great impact on quality of life. Thus, maintaining a healthy sexual life with MS is an important priority. The treatment of SD requires multidisciDlinarv teamwork and coooeration amone specialists,individual patients, partners and the society.

Presenting a Treatment Concept for People with a Self-Reported Sexual Interest in Children in an Outpatient Setting

Results of several studies point to an increase in reported child sexual abuse offences in Germany and an even higher number of undetected cases are assumed. In addition, even more cases regarding the distribution of child pornography have been reported. On behalf of victims of child sexual abuse and for the general public, a preventive treatment approach for people with a sexual interest in children is of prime importance. Currently, there is no published, evaluated therapeutic approach for treating potential offenders, dark field offenders and bright field offenders with a sexual interest in children in an outpatient setting. We designed a cognitive-behavioral therapeutic approach that integrated need- and resource-oriented concepts for the specific treatment of those people. This treatment program comprises thirteen modules and is established for a period of about one and a half years. The therapy concept is presented in detail and we report experiences with two male clients. We found a reduction of child abusive behavior (on- and off-line), cognitive distortions and subjective psychological distress, an increase of the extent of self-perceived sexual self-regulation, life satisfaction and self-efficacy in general and a high level of clients’ satisfaction with the therapy concept. The present therapy concept shows promising results as a potential viable treatment program to protect children by reaching out to people with a self-reported sexual interest in children in an outpatient setting, but further research is necessary.

Elderly Men Sexuality in Ouagadougou (Burkina Faso)

Background: In general, sexuality is a taboo subject. It is more so in elderly people, as it is believed that they do not complain about sexual disorder. Objective: To analyse the sexual activity of elderly men in Ouagadougou, Burkina Faso. Methods: This is a descriptive cross-sectional study on the sexual activity of men aged at least 60 years old. The study was carried out in Ouagadougou, Burkina Faso, from 1st June to 31st August 2014. All consenting males who were aged 60 and above at the time of the study were included. Results: We contacted 652 men, but only 200 responded i.e. a response rate of 30.67%. The age of the respondents was between 60 years and 89 years with a mean age of 66.38 ± 5.72 years. 80.15% of the respondents had at least one sexual intercourse in a month. Erection was considered satisfactory or very satisfactory in 45.8% (60/131) of respondents and 63.36% of them always had orgasm during sexual intercourse. Premature ejaculation was noted in 23.66% of respondents, while a decline in libido was noted in 82.44% of them. Conclusion: This study which is the first of its kind in Burkina Faso has helped reveal the importance of sexuality in the lives of elderly men.

男性性欲减退症的研究进展

男性性欲减退症(HSDD)是常见的男性性功能障碍,其疾病机制研究总体不足,而分析表明HSDD是多因素相互作用的结果,包括心理学、生物学、疾病和人际因素等。目前,对HSDD治疗的研究主要集中在对原发疾病的治疗以及心理、行为治疗,但尚无安全稳定的药物治疗方法。本文旨在综述HSDD的研究进展,深入了解该疾病的定义、诊断标准、发病机制、主要症状以及治疗方面的研究现状,为今后对该疾病的进一步研究和临床诊治提供帮助。

围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响

目的探讨围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响。方法募集2022年1月至2022年12月于首都医科大学附属北京妇产医院内分泌科就诊的280例40~65岁女性,包括绝经前76例、围绝经期84例和绝经后120例,测量身高、体质量、血压、腰围、臀围等指标,进行包括情绪障碍和性功能障碍等绝经相关症状的问卷调查。将围绝经期及绝经后女性分为情绪障碍组及对照组,性功能障碍组及对照组,采用化学发光免疫法检测血清卵泡刺激素、黄体生成素、雌二醇、孕酮、催乳素浓度,采用液相色谱串联质谱法检测血清性激素结合球蛋白、总睾酮、游离睾酮、生物活性睾酮、脱氢表雄酮、硫酸脱氢表雄酮、雄烯二酮、双氢睾酮浓度。结果与绝经前相比,围绝经期与绝经后女性的血清游离睾酮、生物活性睾酮、雄烯二酮、脱氢表雄酮、硫酸脱氢表雄酮浓度显著降低(P<0.05),但这些激素浓度在围绝经期与绝经后女性中差异无统计学意义(P>0.05);与绝经前相比,围绝经期与绝经后女性血清总睾酮浓度稍降低,但差异无统计学意义(P>0.05);围绝经期与绝经后女性情绪障碍与血清总睾酮浓度降低有关(P<0.05),性功能障碍与血清硫酸脱氢表雄酮浓度降低有关(P<0.05)。结论围绝经期与绝经后女性多种雄激素浓度下降,情绪障碍与血清总睾酮浓度降低有关,性功能障碍与血清硫酸脱氢表雄酮浓度降低有关。

女性性欲评估工具及其研究应用进展

性欲低下障碍是最常见的女性性功能障碍,性欲低下影响了约21.6%的中国女性的生活质量。女性性欲评估工具种类繁多,为方便我国医师和研究者选用合适的工具进行女性性欲低下障碍的相关研究和诊疗工作,本文综述了近十余年国内外可用于这一目的的工具,介绍了包括女性性功能指数、女性性兴趣和性欲量表、性功能问卷、性欲量表、女性性欲减退筛查表在内的17个工具的研究应用进展及优缺点,并就不同应用目的给出了工具建议。

本体感觉训练配合生物反馈电刺激对产后盆底肌功能及性功能的影响

目的探讨本体感觉训练配合生物反馈电刺激对产后盆底肌功能及性功能的影响。方法选取2020年2月至2021年9月在东山县医院妇产科接受盆底肌康复治疗的96例患者作为研究对象,根据随机数字表法将患者分为对照组和观察组,每组48例。对照组采用生物反馈电刺激疗法,观察组采用本体感觉训练配合生物反馈电刺激治疗。比较两组患者盆底肌电压、盆底肌功能、盆底肌力及性功能。结果治疗后,两组患者盆底肌平均电压值、阴道动态压、Ⅰ类和Ⅱ类肌纤维疲劳度较治疗前均上升,且观察组各项指标均优于对照组(P<0.05)。与治疗前比较,治疗后两组盆底障碍影响简易问卷7(PFIQ-7)、盆腔器官脱垂量表(POP-Q)评分均下降,两组间比较观察组更低(P<0.05)。治疗后两组骨盆底肌力(Oxford)评分较治疗前均上升,且观察组更高(P<0.05)。治疗后两组疼痛评分下降,满意度、性高潮、阴道润滑、性兴奋及性欲望各维度分值较治疗前均上升,两组组间比较,疼痛评分观察组偏低(P<0.05),其余评分观察组偏高(P<0.05)。结论本体感觉训练联合生物反馈电刺激有助于改善产后盆底功能障碍患者产后盆底肌功能和性功能。

妊娠期高血压疾病患者外周血miR-15-5P和妊娠相关血浆蛋白A水平动态监测的价值分析

目的探讨动态监测外周血微小RNA-15-5P(miR-15-5P)和妊娠相关血浆蛋白A(PAPP-A)水平在妊娠期高血压疾病(HDCP)患者治疗中的临床价值。方法回顾性分析2019年7月至2021年6月于唐山市妇幼保健院就诊的165例HDCP患者的临床资料,纳入病例组,并根据病情严重程度分为妊娠高血压组(n=67)、轻度子痫前期组(n=63)、重度子痫前期组(n=35);选择同期在同一医院产检的91例正常妊娠女性作为对照组。所有研究对象均留取孕10、20、36周及产后1周的空腹静脉血,采用荧光定量聚合酶链反应(PCR)法测定miR-15-5P的表达水平,酶联免疫吸附试验(ELISA)法测定PAPP-A的血清含量。结果病例组和对照组的miR-15-5P水平均随着孕周的增加而降低,PAPP-A水平随着孕周的增加而升高,两组任意时间点的差异均具有统计学意义(P<0.05)。病例组在孕10、20、36周及产后1周的miR-15-5P水平均低于对照组,且妊娠高血压组、轻度子痫前期组、重度子痫前期组同一时间点依次降低,差异均具有统计学意义(P<0.05)。病例组在孕10、20、36周及产后1周的PAPP-A水平均高于对照组,且妊娠高血压组、轻度子痫前期组、重度子痫前期组同一时间点依次升高,差异均具有统计学意义(P<0.05)。结论动态监测外周血miR-15-5P和PAPP-A水平变化能够反映不同时期HDCP患者的严重程度,对判断该疾病的发生发展有一定的价值。

精神障碍性侵案51例司法精神医学鉴定分析

目的 探讨精神障碍者性侵案例的特征。方法 用自编量表收集2019-2021年经司法精神医学鉴定的51例精神障碍者性侵案例中有关被鉴定人一般人口学特征、案件特征、刑事责任能力评定结果及受害人的年龄、职业分布、文化程度等方面的资料,并进行回顾性统计学分析。结果 51例精神障碍者性侵案例中,被鉴定人以青壮年、无业、初中及以下文化者居多;案件性质为猥亵案占比80.39%、强奸案占比19.61%,作案场所选择公共场所者比例最高,41.18%为家人报案;医学诊断意见中,精神发育迟滞占比47.06%、精神分裂症占比29.41%、其他(包括情感障碍、性心理障碍、器质性精神障碍)占比23.53;最终经过司法精神医学鉴定的被鉴定人中被评定为完全刑事责任能力、限定刑事责任能力、无刑事责任能力者分别占比35.29%、41.18%、23.53%。受害人中14岁以下的女童占64.71%;学生和幼儿是主要群体;初中以下文化程度者占比90.20%。结论 在加强对精神障碍者进行诊疗和监管的同时,需要加强儿童防性侵能力的建设,有必要构建社会、学校和家庭等多位一体的儿童防性侵安全体系,以预防和减少该类案例的发生。

Drug flibanserin–in hypoactive sexual desire disorder

Hypoactive sexual desire disorder(HSDD)is a widely known type of female sexual dysfunction that could also cause emotional distress and relationship problems.Flibanserin,a benzimidazole,was being studied as a treatment for premenopausal women with hypoactive sexual desire disorder because there was no accurate drug therapy available at the time(HSDD).The US Food and Drug Administration(FDA)approved Flibanserin in 2015 for the treatment of generalised acquired HSDD in premenopausal women.It has a high affinity for postsynaptic 5-HT-1A receptors(agonist)and 5-HT-2A receptors(antagonist),and it tends to work by increasing dopamine and noradrenaline levels in the brain while decreasing serotonin levels.This review was to assess Flibanserin efficacy and safety and it is found the drug Flibanserin benefits did not outweigh the risks in premenopausal and postmenopausal women.

推荐一种性发育异常的分类

鉴于生殖医学基础理论的发展，性发育异常原按真、假两性畸形分类已不足反映各种类型的性发育异常。作者根据性别发育过程，选择控制性别关键的性染色体、性腺、与性激素三大类，作为分类基础，在临床十余年间所遇４１７例１２类性发育异常均能归入这三大类中。本分类尚未包括某些少见病例。